Mr. Speaker, I am pleased to rise today to speak to the NDP opposition motion on pharmacare.

The motion states, “millions of Canadians lack prescription drug coverage”. It goes on to say, “the Parliamentary Budget Officer, has concluded that every Canadian could be covered by a universal pharmacare program while saving billions of dollars every year”. The motion ends my calling on the government “to commence negotiations with the provinces no later than October 1, 2018, in order to implement a universal pharmacare program.”

One must ask this. Do the provinces and territories in Canada want this and has there been a discussion between the governments? We all know the federal government's role is to provide health care funding, via Canada health transfers, to the provinces and territories to support the principles of the Canada Health Act.

Federal, provincial, and territorial governments all offer drug insurance plans, providing some coverage to approximately 53% of the Canadian population. Each jurisdiction stipulates the specific eligibility requirements for its population and the specific drugs it will cover, as well as any cost-sharing measures required. Jurisdictions typically provide some level of drug insurance for specific populations or individuals meeting some eligibility requirements. Most of these plans typically cover seniors, low-income families, or individuals.

The health needs of each province's population, prescribing habits of physicians, generic drug pricing, and price negotiations vary. Provincial drug plans vary in their determination of the patient's co-payments, for example, a fixed co-payment and a means-tested co-payment.

Provinces also set different thresholds for both the income and the drug expenditure. Thus, a patient's out-of-pocket expenditure can vary, depending on which province or territory he or she lives in. We must also take into consideration private plans that individuals have across the country, which may exceed the provincial coverage. How would the proposed motion affect these plans?

According to a study by the Commonwealth Fund, 8% of Canadians with below-average incomes said that they had not filled a prescription or had skipped doses in the previous year because of cost. Although there is room for improvement, this is on par with Germany, which also had 8% of its people not fill their prescriptions, and is notably better than France at 11%, Australia at 14%, and New Zealand at 18%. I would stress these countries have national pharmacare programs. It is obvious people are more concerned about patients not taking the medication even though they have a national pharmacare program.

Canadians should be wary of replacing our mixed system with something like what exists in the U.K. or New Zealand. Socializing a larger part of drug spending through a single-payer pharmacare plan would give more power to government and its bureaucrats to make decisions on behalf of the insured. Policies that restrict access to new medicines would be applied across the board and would penalize all Canadians in the same way.

However, replacing our current mixed public-private plans, administered by the provinces, with a national drug insurance monopoly is definitely not the solution. It would harm Canadians, putting patients at risk and increasing the cost of our health care system in the long run. Would one plan fit all segments of the country? I do not think so, due to provincial and territorial jurisdictions, as well as private health plans negotiating, individually, the best prices for prescription drugs.

If there is only one buyer and our federal government is in control, common sense tells me the cost for prescriptions would be much higher.

A 2002 study estimated that 11% of Canadians faced the risk of high prescription drug costs, 2% because they lacked coverage and approximately 9% because they were under-insured.

Prescription drug expenditures in Canada were $28.8 billion in 2014. When adjusted for inflation, out-of-pocket expenditures on prescription drugs per capita amounted to $180, rounded off, in 2014. Prescription drug expenditures have three components: the drug cost; the dispensing fees charged by pharmacists; and the pharmacy markup, where applicable.

In 2012 and 2013, drug costs made up 74.4% of prescription drug expenditures in the public drug plans in Canada, whereas dispensing fees accounted for 21.4% and wholesale markup accounted for 4.2% of expenditures.

The motion before us today begs the question. How do we pay for a national pharmacare program when the parliamentary budget officer says it would cost $22.6 billion annually? That is just an estimate. We have only to look at what took place today. The energy east pipeline failed because of government bureaucracy, red tape, and restrictions. Fifteen thousand jobs will not exist and revenue will not come into our country. Money does not grow on trees.

The 2016 census stated that the portion of working-age population, those between the ages of 15 and 64, declined from 68.5% in the 2011 census to 66.5% in the recent one. Results from the 2016 census from Statistics Canada shows the proportion of those aged 65 and older, including myself, climbed to 16.9% of Canada's population. We now exceed the share of those less than 15 years of age, who are at roughly 16.6%. These statistics tell me that the costs will be much higher. I do not believe I ever took any medication when I was under 15, but I take a little off and on now.

What the Conservative Party is concerned about is the lack of data and the high initial cost of implementing a national pharmacare program. The share of drug spending paid for by each payer differs substantially across age groups.

Unfortunately, what concerns me is that the out-of-control spending and deficits of the Liberal Government will make it extremely difficult for any meaningful federal investments in health care or any other social program. The Conservative Party supports a high-quality, sustainable health care system that ensures Canadians get the best possible care. I believe that Canada's health care system is envied around the world.

When I have travelled over the last few years, I have talked to strangers about their health care programs and their governments, and they are envious of what we have in Canada. However, I always say that we can always make things better.

Prescribed drug expenditures account for just 13.4% of Canada's total health spending, which is $214 billion a year. A singular preoccupation on pharmaceutical cost containment risks missed opportunities for cost savings in other areas of the health system through improved medication adherence, early detection, chronic disease management, and preventive health measures.

The Canadian Pharmacists Association's website in January 2016 stated that a “national discussion on a pan-Canadian pharmacare framework requires clear evidence for policymakers and a clear national consensus on priorities important to Canadians.” That is very important. Our Conservative Party wants to ensure that Canadians receive the best health care possible and that the most vulnerable have access to the most innovative drugs. We need to have fair drug prices and access to necessary medications. Patients also require access to the full range of pharmacy services, such as prescription renewals, care plans, and prescription modifications to ensure safe and effective drug therapy.

A national pharmacare program raises a number of the following questions. What would be the short-term costs? Would these costs be affordable to government? What would be the role of the federal government? What drugs would be covered by the drug plan? What criteria would be used in deciding who gets them? How would the added costs be split between the federal government and the provinces and territories? How would a national pharmacare program affect drug prices?